All community-based studies focus on socio-economic stratification as this is the key to understanding affordability of health services, amenities, and purchasability. When it is taken as a summation of education, occupation, and income, it reflects the value system expected for that level of education and occupation. Income is parallel to standard of living. Socio Economic Status (SES) is established determinant of health. Kuppuswamy's socioeconomic status is an important tool in hospital and community-based research in India, which was originally proposed in 1976. [1]

Need for revision

Realizing the value of this important tool, we need to keep this updated as the price index is increasing (as this scale is consumer price index based). If it is not revised, it will lose its utility. Mishra undertook the important task of revision of family income per month for 1998 using base year 1982 = 100.3 Presently, the base year has been changed from 1982 to current base year 2001. [2]

As Kuppuswamy's SES for the urban areas continues to enjoy respect among the public health professionals, an attempt is being made using the new base year of 2001 for CPI-IW (All India average consumer price index for industrial workers) to update Kuppuswamy scale as per CPI-IW of November 2012 to facilitate the desire of public health workers for an updated version.

Kuppuswamy's original income groups of family for 1976 were based on 1960 as 100 (base). [3] As the prices for 2012 have increased manifold compared to 1960 and that increase can be obtained by multiplying original income groups with current CPI prices with a multiplication factor 0.0735. The multiplication factor is needed to convert the value of 1960 base to the current base of 2001.

Current income groups = Original family income groups of Kuppuswamy (1976) × Current Consumer Price Index × 0.0735 (multiplication factor)

CPI-IW (Base 2001 = 100) shows the current Price index as 218 on November 2012. [4] Hence, the current income groups are obtained as follows:

2000 × 218 × 0.0735 = 32050 (rounded off to nearest ten for the lower limits of the respective income groups)

The other two variables education and occupation should also be reviewed and needs few changes. As per Population Census of India 2011, the Literacy rate of India has shown as an improvement of almost 9%. It has gone up to 74.04% in 2011 from 65.38% in 2001. [5] Hence, the score of education needs to be revised as follows:

Professional/Honors - 4

Graduate/ Post graduate - 3

High school/ Intermediate/Diploma - 2

Illiterate/Primary school - 1

Ministry of labor in India had revised occupation descriptions in 2004 (Revised Indian National Classification of Occupations). [6]

Previously, there was an overemphasis on income (no scale is ever complete in assessing actual SES and they are only at the best surrogates and generates uniformity in spite of limitations) rather than educational and occupational factors, but nevertheless income commensurate with education and occupation. We have revised occupational and educational variables in Kuppuswamy scale. This speaks about the utility of Kuppuswamy scale; the revision enables and equips community-related scientists in their quest for socioeconomic status.